Public Protection Budget Consultation 2015/2016 Caroline Baria - PowerPoint PPT Presentation

Adult Social Care, Health and Public Protection Budget Consultation 2015/2016 Caroline Baria Service Director, Personal Care and Support, South Nottinghamshire

Our Principles • April 2014 – At Full Council, elected members agreed to adopt the Adult Social Care Strategy • Strategy will ensure sustainable, fair and equitable social care provision which provides residents with an enhanced quality of life and is affordable now and in the future • There are three underpinning principles which form the foundation of the Adult Social Care Strategy: – Promoting independence and wellbeing – Ensuring value for money – Promoting choice and control

Our Charter for Adult Social Care  We will promote individual health, well-being and independence  We will share responsibility for maintaining the health and well-being of people in our communities with families, carers, friends and other organisations  We will work to prevent or delay the development of needs for care and support by providing advice, information and services that support independence  We will promote choice and control so people can receive support in ways that are meaningful to them, but will balance this against the effective and efficient use of our resources  We will work to ensure people are protected from significant harm whilst allowing people to take risks  We will always seek the most cost effective way to provide support, in order to ensure we can continue to meet the needs of all people who are eligible for care and support

Redefining your Council: Adult Social Care and Health portfolio Five programmes of work within the portfolio to support transformation of adult social care: 1. Implementation of the Adult Social Care Strategy and facilitation of the market 2. Care Act implementation 3. Integration with Health 4. Direct Services provision 5. Public Health outcomes

Budget proposals – impact on Health Savings ID Proposal Key issues (£m) • C02 Older Adults Care Review of the 5 band pricing structure and consult on a £0.746m Home Fees more simplified fee payment structure which is transparent, equitable and consistent, for people who are funded by the Council and people who pay for their own care. Proposed that Council will continue to implement a quality recognition system. • Average care home fee currently paid by the Council is £501.70 per week, while the mid-point of the current banding system for residential care is £471.00 per week Should the Council move to a simplified flat rate system near to the current mid-point then the potential savings would be at least £650k. • Process will include reviewing a small number of older adults’ placements where the residents are currently funded at a different fee level outside of the current bandings framework. • CCGs will benefit from reduced fee levels, but also requesting some funding to support implementation.

Budget proposals – impact on Health Savings ID Proposal Key issues (£m) B01 Review of Intermediate £1.600m Emerging joint social care and health projects within the Care three CCG units of planning (south, mid and north Nottinghamshire) are seeking to define future integrated service models for Intermediate Care (IC), Reablement and other hospital discharge service requirements. Proposal is to jointly design a model that will deliver savings through avoiding care home admissions, including significant reductions in long term placements made directly from hospital. Within these models the Council maintains the following principles when defining future services: • Prioritise funding for IC and Reablement services which can evidence avoidance of, or delay in, the need for social care packages, including residential care • Target service to those who would benefit most from it. • Focus on avoiding care home and hospital admissions where possible, and on hospital discharge. Any of the savings that cannot be achieved through reducing long term care admissions will need to be delivered by reducing the social care IC budget.

Budget proposals – impact on Health Savings ID Proposal Key issues (£m) C03 Development of Extra From 2015 onwards the Council together with external £4.346m Care Housing and partners and the District and Borough authorities will be promotion of opening additional extra care facilities across the county. independent living The current County Council operated residential care instead of our current centres would be decommissioned as the new extra care provision of 6 Care and facilities are opened. This would impact on future Support Centres. availability of intermediate care and assessment beds. Should this option be approved following consultation, in the short term and pending decommissioning, the Council would use the Care and Support Centres to provide short term care and assessment, and not admit anyone on a long term basis in order that fewer people would have to be relocated in the longer term. Reduction in posts: 110 during 2015/16; 111 during 2016/17.

Budget proposals – impact on Health Savings ID Proposal Key issues (£m) C05 Expansion of £0.250m Transformative proposal aimed at people who are eligible community based care for service from the Council, but need relatively low levels and support options of support to enable them to be socially included and active within their community. Suggestions for alternative service provision include: 1. Expansion of the co-production model to other client groups (in addition to Mental Health). 2. Greater use of Shared Lives carers to provide support during the day. 3. Greater use of digital technology and social networking to link people together, e.g. People and Places model.

Budget proposals – impact on Health ID Proposal Key issues Savings (£m) C06 Reducing the average Proposal seeks to reduce the cost of packages through £2.500m cost of younger negotiations with the care providers, rather than by moving adults’ residential people into alternative living arrangements by: placements 1. Carrying out focused reviews for residents with high cost care packages and significant additional support hours. 2. Working with providers to understand their staffing rotas. 3. Reviewing how the Care Funding Calculator (CFC) is used. 4. Developing a culture that expects the promotion of independence over time. 5. Strategic review of the residential market for younger adults. Additional staffing is required to provide capacity to undertake the reviews and negotiations. CCGs will benefit from reduced fee levels - we are asking our health partners to contribute 50% of the funding for the individual placement work, as significant proportion of the savings will be realised by the NHS since many of the most complex people have joint funding packages. The total cost requested is £ 76k p.a. (in total across all 6 CCGs) for 3 years.

Budget proposals – impact on Health ID Proposal Key issues Savings (£m) C07 Contract Reviews Continence training and awareness package for social £0.129m care staff and carer s: reduced, more focused level of training will be funded for social care staff and carers for one year whilst a full review is undertaken. The Continence Advisory Services (CAS) - (NHS City Care and Nottinghamshire Healthcare Trust) will provide a more targeted interim service, with a view to social care ceasing funding from April 2016 with a view to this being incorporated into main incontinence contract with lead CCG Carers’ Information, Advice and Engagement Hub : Outcomes from four existing contracts will be re- commissioned in partnership with CCGs to develop a joint specification for a new Carers’ Information, Advice and Engagement Hub, with the new service starting in Aug 2015. This will be cost effective as well as offering an enhanced service, with fairer and wider coverage of carer support. It is proposed that the CCGs and the Council will jointly consult and engage with carers.

Budget proposals – impact on Health Savings ID Proposal Key issues (£m) B02 HPAS In 2013/14 a total of 1,085 key safe units were fitted (at a £0.100m cost of £92,272) - 736 were from hospital or self-referrals for fast installation to support hospital discharge (at a cost of £65,000). Hospital discharge element of service was added to the original scheme following successful pilot project, but without longer term funding being agreed. Demand for this element of the service has grown rapidly as people are helped to return home earlier from hospital. Request for each CCG to contribute to the cost of the service (£16.7k) from April 2015 given focus on swift hospital discharge. Services that show good outcomes for reducing the need for social care are already planned to re-focus on three key areas of Older People, Mental Health and Vulnerable Adults. It is proposed that: 1. Social Care and Public Health jointly commission Short Term Prevention B03 targeted, short term prevention support, combined for both £0.200m Services older and younger adults as a means of achieving a saving of £200,000. 2. The service will focus on the requirements of the Care Act and developing a sustainable service that is effective in preventing or reducing people’s need for services.